Dementia with lewy bodies
Seniors who suffer from a relatively common neurological disease called dementia with lewy bodies (DLB) – abnormal substances inside nerve cells – are extremely sensitive to certain antipsychotic drugs and should avoid taking them. Such drugs can cause further physical deterioration and possibly death, says Dr. Morris Freedman, director of the behavioural neurology program at the Baycrest Centre for Geriatric Care in Toronto.

Symptoms and diagnosis
DLB can be difficult to diagnose because its symptoms are similar to those of Alzheimer's and Parkinson's diseases. In addition to Parkinson's-like symptoms (flexed posture, shuffling gait and a tendency to fall) and wide fluctuations in cognitive ability, symptoms of DLB can include inattentiveness, indecision and lack of judgment.

But it's the visual or auditory hallucinations – another core feature of DLB but not of Parkinson's – that can lead to significant health problems. Doctors typically control hallucinations with neuroleptics, but they can be lethal for patients with DLB. “Neuroleptics can induce severe immobility, Parkinsonism or death,” says Freedman. “Patients can become so immobile that they develop pneumonia and die.” It's unclear why DLB patients have such a hypersensitivity to neuroleptics, he says. Another class of drugs – cholinesterase inhibitors, which are used to treat Alzheimer's disease – may be beneficial in treating DLB, says Freedman.

Who is at risk?
In many hospitals, DLB is the second most common cause of dementia after Alzheimer's disease. DLB usually afflicts people between the ages of 50 and 80, and men are at greater risk of developing it than women. The cause of DLB remains unknown, although researchers are investigating a possible genetic link.

This story was originally from the October 2003 issue. Subscribe to Canadian Living today and never miss an issue!


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